please assist me in my financial analytical report

Metropolis Health System (MHS) offers comprehensive healthcare services. It is a mid- BACKGROUND 1. The Hospital System size taxing district hospital. Although MHS has the power to raise revenues through taxes, it has not done so for the past seven years. a 2. The Area MHS is located in the town of Metropolis, which has a population of 50,000. The town has a small college and a modest number of environmentally clean industries. 3. MHS Services MHS has taken significant steps to reduce hospital stays. It has developed a comprehen- sive array of services that are accessible, cost-effective, and responsive to the community's needs. These services are wellness oriented in that they strive for prevention rather than treatment. As a result of these steps, inpatient visits have increased overall by only 1,000 per year since 2010 whereas outpatient/same-day surgery visits have had an increase of over 50,000 per year. A number of programmatic, service, and facility enhancements support this major transi- tion in the community's institutional health care. They are geared to provide the quality, convenience, affordability, and personal care that best suit the health needs of the people whom MHS serves. Rehabilitation and Wellness Center--for outpatient physical therapy and return-to- work services, plus cardiac and pulmonary rehabilitation, to get people back to a nor- mal way of living Home Health Services-bringing skilled care, therapy, and medical social services into the home; a comfortable and affordable alternative in longer-term care. Same-Day Surgery (SDS)-eliminating the need for an overnight stay. Since 2010 same-day surgery procedures have doubled at MHS. . Skilled Nursing Facility--inpatient service to assist patients in returning more fully to an independent lifestyle. The medical staff's quality improvement program has begun a care path initiative to track effective means for diagnosis, treatment, and follow-up. This initiative will help Metropolis Health Foundation is presently being created to serve as the philanthropic arm of MHS. It will operate in a separate corporation governed by a board of 12 com- avoid unnecessary or duplicate use of expensive medications or technologies. 9. MHS Foundation munity leaders and supported by a 15-member special events board. The mission of the foundation will be to secure financial and nonfinancial support for realizing the MHS vision of providing comprehensive health care for the community. Funds donated by individuals, businesses, foundations, and organizations will be desig- nated for a variety of purposes at MHS, including the operation of specific departments, community outreach programs, continuing education for employees, endowment, equip- ment, and capital improvements. 10. MHS Volunteer Auxiliary There are 500 volunteers who provide over 60,000 hours of service to MHS each year. These men and women assist in virtually every part of the system's operations. They also conduct community programs on behalf of MHS. The auxiliary funds its programs and makes financial contributions to MHS through money it raises on renting televisions and vending gifts and other items at the hospital. In the past, its donations to MHS have generally been designated for medical equipment purchases. The auxiliary has given $250,000 over the last five years. 11. Planning the Future for MHS The MHS has identified five areas of desired service and programmatic enhancement in its five-year strategic plan: 1. Ambulatory Services II. Physical Medicine and Rehabilitative Services III. Cardiovascular Services IV. Oncology Services V. Community Health Services MHS has set out to answer the most critical health needs that are specific to its commu- nity. Over the next five years, the MHS strategic plan will continue a tradition of quality, community-oriented health care to meet future demands. 12. Financing the Future MHS has established a corporate depreciation fund. The fund's purpose is to ease the financial burden of replacing fixed assets. Presently, it has almost $2 million for needed equipment and renovations. ULTY Exhibit 33-1 Balance Sheet Metropolis Health System Balance Sheet March 31, 2_ Liabilities and Fund Balance Current Liabilities $525,000 4,900,000 300,000 Assets Current Assets Cash and Cash Equivalents $1,150,000 Assets Whose Use Is Limited 825,000 Patient Accounts Receivable 7,400,000 (Net of $1,300,000 Allowance for Bad Debts) Other Receivables 150,000 Inventories 900,000 Prepaid Expenses 200,000 Total Current Assets 10,625,000 Assets Whose Use Is Limited Corporate Funded Depreciation 1,950,000 Held by Trustee Under Bond Indenture Agreement 1,425,000 Total Assets Whose Use Is Limited 3,375,000 Less Current Portion (825,000) Net Assets Whose Use Is Limited 2,550,000 Property, Plant, and Equipment, Net 19,300,000 Other Assets 325,000 Total Assets $32,800,000 Current Maturities of Long-Term Debt Accounts Payable and Accrued Expenses Bond Interest Payable Reimbursement Settlement Payable Total Current Liabilities 5,825,000 Long-Term Debt 6,000,000 Less Current Portion of Long-Term Debt (525,000) Net Long-Term Debt 5,475,000 Total Liabilities 11,300,000 100,000 Fund Balances General Fund Total Fund Balances 21,500,000 21,500,000 Total Liabilities and Fund Balances $32,800,000 Lithibit 33-2 Statement of Revenue and Expense Metropolis Health System Statement of Revenue and Expense for the Year Ended March 31,2__ Revenue $34,000,000 1,100,000 $35,100,000 Net patient service revenue Other revenue Total Operating Revenue Expenses Nursing services Other professional services General services Support services Depreciation Amortization Interest Provision for doubtful accounts $5,025,000 13,100,000 3,200,000 8,300,000 1,900,000 50,000 325,000 1,500,000 33,400,000 Total Expenses $1,700,000 Income from Operations $20,000 80,000 100,000 Nonoperating Gains (Losses) Unrestricted gifts and memorials Interest income Nonoperating Gains, Net $1,800,000 Revenue and Gains in Excess of Expenses and Losses Shibit 33-4 Statement of Changes in Fund Balance Metropolis Health System Statement of Changes in Fund Balance for the Year Ended March 31,2_ General Fund Balance April 1, 2 $19,700,000 Revenue and Gains in Excess of Expenses and Losses 1,800,000 General Fund Balance March 31, 2 $21,500,000 Exhibit 33-5 Schedule of Property, Plant, and Equipment Metropolis Health System Schedule of Property, Plant, and Equipment for the Year Ended March 31, 2 $14,700,000 Buildings and Improvements 1,100,000 Land Improvements 28,900,000 Equipment $44,700,000 Total (26,100,000) Less Accumulated Depreciation $18,600,000 Net Depreciable Assets 480,000 Land 220,000 Construction in Progress $19,300,000 Net Property, Plant, and Equipment Exhibit 33-6 Schedule of Patient Revenue Metropolis Health System Schedule of Patient Revenue for the Year Ended March 31, 2 Patient Services Revenue Routine revenue Laboratory Radiology and CT scanner OB-nursery Pharmacy Emergency service Medical and surgical supply and IV Operating rooms Anesthesiology Respiratory therapy Physical therapy EKG and EEG Ambulance service Oxygen Home health and hospice Substance abuse Other $9,850,000 7,375,000 5,825,000 450,000 3,175,000 2,200,000 5,050,000 5,250,000 1,600,000 900,000 1,475,000 1,050,000 900,000 575,000 1,675,000 375,000 775,000 Subtotal Less allowances and charity care $48,500,000 Net Patient Service Revenue (14,500,000 $34,000,000 Athibit 33-7 Schedule of Operating Expenses Metropolis Health System Schedule of Operating Expenses for the Year Ended March 31,2_ Nursing Services Routine Medical/Surgical General Services Dietary Maintenance Laundry Housekeeping Security Medical Records $3,880,000 300,000 395,000 150,000 300,000 $5,025,000 Operating Room Intensive Care Units OB-Nursery Other Total $1,055,000 1,000,000 295,000 470,000 50,000 330,000 $3,200,000 Total Support Services General Insurance Payroll Taxes Employee Welfare Other Total $4,600,000 240,000 1,130,000 1,900,000 430,000 $8,500,000 Other Professional Services Laboratory $2,375,000 Radiology and CT Scanner 1,700,000 Pharmacy 1,375,000 Emergency Service 950,000 Medical and Surgical Supply 1,800,000 Operating Rooms and Anesthesia 1,525,000 Respiratory Therapy 525,000 Physical Therapy 700,000 EKG and EEG 185,000 Ambulance Service 80,000 Substance Abuse 460,000 Home Health and Hospice 1,295,000 130,000 $13,100,000 Depreciation Amortization 1,900,000 50,000 325,000 Interest Expense 1,500,000 Provision for Doubtful Accounts Other Total Total Operating Expenses $33,400,000 51.480 34.050 Exhibit 33-8 Hospital Statistical Data Metropolis Health System Schedule of Hospital Statistics for the Year Ended March 31,2 Inpatient Indicators: Departmental Volume Indicators: Patient Days Medical and surgical 13,650 Respiratory therapy treatments Obstetrics 1.080 Physical therapy treatments Skilled nursing unit 4,500 Laboratory workload units (in thousands) Admissions EKGs Adult acute care 3,610 CT scans Newborn 315 MRI scans Skilled nursing unit 440 Emergency room visits Ambulance trips Discharges Home health visits Adult acute care 14,950 3,580 Newborn 315 Approximate number of employees Skilled nursing unit 445 (FTE) 510 Average Length of Stay (in days) 4.1 2.750 8,900 2,780 910 11.820 2.320 Director of Nurses Finance Information Systems Support TO Education Recruitment Support Ambulatory Nursing Medical Surgical Emergency Nursing Women's Health Pediatric Nursing MRI Medical OB/GYN Children's Medicine Dialysis Surgical Pediatric Medicine Health 8 Development Oncology Emergency Cardiac Rehab Exhibit 33-3 Statement of Cash Flows Metropolis Health System Statement of Cash Flows for the Year Ended March 31,2_ Statement of Cash Flows $1,700,000 1,950,000 Operating Activities Income from operations Adjustments to reconcile income from operations to net cash flows from operating activities Depreciation and amortization Changes in asset and liability accounts Patient accounts receivable Other receivables Inventories Prepaid expenses and other assets Accounts payable and accrued expenses Reduction of bond interest payable Estimated third-party payer settlements Interest income received Unrestricted gifts and memorials received Net cash flow from operating activities 250,000 (50,000) (50,000) (50,000) (400,000) (25,000) (75,000) 80,000 20,000 $3,350,000 Cash Flows from Capital and Related Financing Activities Repayment of long-term obligations (500,000) Cash Flows from Investing Activities Purchase of assets whose use is limited Equipment purchases and building improvements (100,000) (2,000,000) Net Increase (Decrease) in Cash and Cash Equivalents $750,000 Cash and Cash Equivalents, Beginning of Year 400,000 Cash and Cash Equivalents, End of Year $1,150,000 C. Financial Analytical Report (50 points) Please write an executive summary to Senior Vice President in Finance/CFO. You may use reasonable assumptions to build up your case. Here's the requirement of the report. 1. 1-inch marnin 15 anni Metropolis Health System (MHS) offers comprehensive healthcare services. It is a mid- BACKGROUND 1. The Hospital System size taxing district hospital. Although MHS has the power to raise revenues through taxes, it has not done so for the past seven years. a 2. The Area MHS is located in the town of Metropolis, which has a population of 50,000. The town has a small college and a modest number of environmentally clean industries. 3. MHS Services MHS has taken significant steps to reduce hospital stays. It has developed a comprehen- sive array of services that are accessible, cost-effective, and responsive to the community's needs. These services are wellness oriented in that they strive for prevention rather than treatment. As a result of these steps, inpatient visits have increased overall by only 1,000 per year since 2010 whereas outpatient/same-day surgery visits have had an increase of over 50,000 per year. A number of programmatic, service, and facility enhancements support this major transi- tion in the community's institutional health care. They are geared to provide the quality, convenience, affordability, and personal care that best suit the health needs of the people whom MHS serves. Rehabilitation and Wellness Center--for outpatient physical therapy and return-to- work services, plus cardiac and pulmonary rehabilitation, to get people back to a nor- mal way of living Home Health Services-bringing skilled care, therapy, and medical social services into the home; a comfortable and affordable alternative in longer-term care. Same-Day Surgery (SDS)-eliminating the need for an overnight stay. Since 2010 same-day surgery procedures have doubled at MHS. . Skilled Nursing Facility--inpatient service to assist patients in returning more fully to an independent lifestyle. The medical staff's quality improvement program has begun a care path initiative to track effective means for diagnosis, treatment, and follow-up. This initiative will help Metropolis Health Foundation is presently being created to serve as the philanthropic arm of MHS. It will operate in a separate corporation governed by a board of 12 com- avoid unnecessary or duplicate use of expensive medications or technologies. 9. MHS Foundation munity leaders and supported by a 15-member special events board. The mission of the foundation will be to secure financial and nonfinancial support for realizing the MHS vision of providing comprehensive health care for the community. Funds donated by individuals, businesses, foundations, and organizations will be desig- nated for a variety of purposes at MHS, including the operation of specific departments, community outreach programs, continuing education for employees, endowment, equip- ment, and capital improvements. 10. MHS Volunteer Auxiliary There are 500 volunteers who provide over 60,000 hours of service to MHS each year. These men and women assist in virtually every part of the system's operations. They also conduct community programs on behalf of MHS. The auxiliary funds its programs and makes financial contributions to MHS through money it raises on renting televisions and vending gifts and other items at the hospital. In the past, its donations to MHS have generally been designated for medical equipment purchases. The auxiliary has given $250,000 over the last five years. 11. Planning the Future for MHS The MHS has identified five areas of desired service and programmatic enhancement in its five-year strategic plan: 1. Ambulatory Services II. Physical Medicine and Rehabilitative Services III. Cardiovascular Services IV. Oncology Services V. Community Health Services MHS has set out to answer the most critical health needs that are specific to its commu- nity. Over the next five years, the MHS strategic plan will continue a tradition of quality, community-oriented health care to meet future demands. 12. Financing the Future MHS has established a corporate depreciation fund. The fund's purpose is to ease the financial burden of replacing fixed assets. Presently, it has almost $2 million for needed equipment and renovations. ULTY Exhibit 33-1 Balance Sheet Metropolis Health System Balance Sheet March 31, 2_ Liabilities and Fund Balance Current Liabilities $525,000 4,900,000 300,000 Assets Current Assets Cash and Cash Equivalents $1,150,000 Assets Whose Use Is Limited 825,000 Patient Accounts Receivable 7,400,000 (Net of $1,300,000 Allowance for Bad Debts) Other Receivables 150,000 Inventories 900,000 Prepaid Expenses 200,000 Total Current Assets 10,625,000 Assets Whose Use Is Limited Corporate Funded Depreciation 1,950,000 Held by Trustee Under Bond Indenture Agreement 1,425,000 Total Assets Whose Use Is Limited 3,375,000 Less Current Portion (825,000) Net Assets Whose Use Is Limited 2,550,000 Property, Plant, and Equipment, Net 19,300,000 Other Assets 325,000 Total Assets $32,800,000 Current Maturities of Long-Term Debt Accounts Payable and Accrued Expenses Bond Interest Payable Reimbursement Settlement Payable Total Current Liabilities 5,825,000 Long-Term Debt 6,000,000 Less Current Portion of Long-Term Debt (525,000) Net Long-Term Debt 5,475,000 Total Liabilities 11,300,000 100,000 Fund Balances General Fund Total Fund Balances 21,500,000 21,500,000 Total Liabilities and Fund Balances $32,800,000 Lithibit 33-2 Statement of Revenue and Expense Metropolis Health System Statement of Revenue and Expense for the Year Ended March 31,2__ Revenue $34,000,000 1,100,000 $35,100,000 Net patient service revenue Other revenue Total Operating Revenue Expenses Nursing services Other professional services General services Support services Depreciation Amortization Interest Provision for doubtful accounts $5,025,000 13,100,000 3,200,000 8,300,000 1,900,000 50,000 325,000 1,500,000 33,400,000 Total Expenses $1,700,000 Income from Operations $20,000 80,000 100,000 Nonoperating Gains (Losses) Unrestricted gifts and memorials Interest income Nonoperating Gains, Net $1,800,000 Revenue and Gains in Excess of Expenses and Losses Shibit 33-4 Statement of Changes in Fund Balance Metropolis Health System Statement of Changes in Fund Balance for the Year Ended March 31,2_ General Fund Balance April 1, 2 $19,700,000 Revenue and Gains in Excess of Expenses and Losses 1,800,000 General Fund Balance March 31, 2 $21,500,000 Exhibit 33-5 Schedule of Property, Plant, and Equipment Metropolis Health System Schedule of Property, Plant, and Equipment for the Year Ended March 31, 2 $14,700,000 Buildings and Improvements 1,100,000 Land Improvements 28,900,000 Equipment $44,700,000 Total (26,100,000) Less Accumulated Depreciation $18,600,000 Net Depreciable Assets 480,000 Land 220,000 Construction in Progress $19,300,000 Net Property, Plant, and Equipment Exhibit 33-6 Schedule of Patient Revenue Metropolis Health System Schedule of Patient Revenue for the Year Ended March 31, 2 Patient Services Revenue Routine revenue Laboratory Radiology and CT scanner OB-nursery Pharmacy Emergency service Medical and surgical supply and IV Operating rooms Anesthesiology Respiratory therapy Physical therapy EKG and EEG Ambulance service Oxygen Home health and hospice Substance abuse Other $9,850,000 7,375,000 5,825,000 450,000 3,175,000 2,200,000 5,050,000 5,250,000 1,600,000 900,000 1,475,000 1,050,000 900,000 575,000 1,675,000 375,000 775,000 Subtotal Less allowances and charity care $48,500,000 Net Patient Service Revenue (14,500,000 $34,000,000 Athibit 33-7 Schedule of Operating Expenses Metropolis Health System Schedule of Operating Expenses for the Year Ended March 31,2_ Nursing Services Routine Medical/Surgical General Services Dietary Maintenance Laundry Housekeeping Security Medical Records $3,880,000 300,000 395,000 150,000 300,000 $5,025,000 Operating Room Intensive Care Units OB-Nursery Other Total $1,055,000 1,000,000 295,000 470,000 50,000 330,000 $3,200,000 Total Support Services General Insurance Payroll Taxes Employee Welfare Other Total $4,600,000 240,000 1,130,000 1,900,000 430,000 $8,500,000 Other Professional Services Laboratory $2,375,000 Radiology and CT Scanner 1,700,000 Pharmacy 1,375,000 Emergency Service 950,000 Medical and Surgical Supply 1,800,000 Operating Rooms and Anesthesia 1,525,000 Respiratory Therapy 525,000 Physical Therapy 700,000 EKG and EEG 185,000 Ambulance Service 80,000 Substance Abuse 460,000 Home Health and Hospice 1,295,000 130,000 $13,100,000 Depreciation Amortization 1,900,000 50,000 325,000 Interest Expense 1,500,000 Provision for Doubtful Accounts Other Total Total Operating Expenses $33,400,000 51.480 34.050 Exhibit 33-8 Hospital Statistical Data Metropolis Health System Schedule of Hospital Statistics for the Year Ended March 31,2 Inpatient Indicators: Departmental Volume Indicators: Patient Days Medical and surgical 13,650 Respiratory therapy treatments Obstetrics 1.080 Physical therapy treatments Skilled nursing unit 4,500 Laboratory workload units (in thousands) Admissions EKGs Adult acute care 3,610 CT scans Newborn 315 MRI scans Skilled nursing unit 440 Emergency room visits Ambulance trips Discharges Home health visits Adult acute care 14,950 3,580 Newborn 315 Approximate number of employees Skilled nursing unit 445 (FTE) 510 Average Length of Stay (in days) 4.1 2.750 8,900 2,780 910 11.820 2.320 Director of Nurses Finance Information Systems Support TO Education Recruitment Support Ambulatory Nursing Medical Surgical Emergency Nursing Women's Health Pediatric Nursing MRI Medical OB/GYN Children's Medicine Dialysis Surgical Pediatric Medicine Health 8 Development Oncology Emergency Cardiac Rehab Exhibit 33-3 Statement of Cash Flows Metropolis Health System Statement of Cash Flows for the Year Ended March 31,2_ Statement of Cash Flows $1,700,000 1,950,000 Operating Activities Income from operations Adjustments to reconcile income from operations to net cash flows from operating activities Depreciation and amortization Changes in asset and liability accounts Patient accounts receivable Other receivables Inventories Prepaid expenses and other assets Accounts payable and accrued expenses Reduction of bond interest payable Estimated third-party payer settlements Interest income received Unrestricted gifts and memorials received Net cash flow from operating activities 250,000 (50,000) (50,000) (50,000) (400,000) (25,000) (75,000) 80,000 20,000 $3,350,000 Cash Flows from Capital and Related Financing Activities Repayment of long-term obligations (500,000) Cash Flows from Investing Activities Purchase of assets whose use is limited Equipment purchases and building improvements (100,000) (2,000,000) Net Increase (Decrease) in Cash and Cash Equivalents $750,000 Cash and Cash Equivalents, Beginning of Year 400,000 Cash and Cash Equivalents, End of Year $1,150,000 C. Financial Analytical Report (50 points) Please write an executive summary to Senior Vice President in Finance/CFO. You may use reasonable assumptions to build up your case. Here's the requirement of the report. 1. 1-inch marnin 15 anni